ICU液气胸患者应用中心静脉导管行闭式引流的疗效评价

Evaluation of the Efficacy of Thoracic Drainage by Central Venous Catheter to Treat the Patients with Pneumothorax or Hydrothorax in ICU

目的:评价应用中心静脉导管行胸腔闭式引流治疗液气胸的效果。方法:选取2011年9月-2015年8月我科收治的气胸及胸腔积液患者62例。其中应用中心静脉导管组29例(包括气胸患者4例),穿刺置入一次性中心静脉导管,末端接引流袋;胸导管组33例,常规置入直径1cm的硅橡胶管,末端接水封瓶。比较两种治疗方法的治疗成功率、严重并发症发生率、术后镇痛药使用率、切口感染发生率及切口愈合时间。结果:两组的治疗成功率相当(P>0.05),中心静脉导管组的并发症、术后镇痛药使用率、切口感染发生率及切口愈合时间明显低于胸导管组(P<0.05)。结论:中心静脉导管治疗液气胸和传统胸管比较,效果好,且并发症少、创伤小、操作简单,值得临床推广。

Objective：To evaluation the efficacy of closed thoracic drainage by central venous catheter for pneumothorax or hydrothorax in ICU.Methods：62cases of hydrothorax or pneumothorax occurred in the course of treatment in the ICU were selected in the period September 2011 to August 2015.They were randomly divided into the central venous drainage group（n=29,including 4cases of pneumothorax）and chest tube group（n=33）.In the central venous drainage group,after percutaneous pleural puncture,central venous catheter was implanted by the guidance of guide wire and fixed on the patients＇ chests.The catheter was connected to a sterile drainage bag.In the conventional chest tube therapy group,the silicone rubber tube which diameter is 1cm was implanted,the ends meeted seal bottles.The clinical efficacy,analgesic usage,complications and so on,were compared.Results：The cure rate between the two groups had no differ（P0.05）.The complications,postoperative analgesic usage,the incidence of wound infection and wound healing time of central venous drainage group were significantly lower than the chest tube group（P0.05）.Conclusion：Closed thoracic drainage treatment by central venous catheter for pneumothorax or hydrothorax is effective,less invasive,and simple,has fewer complications,and worth widely of clinical application.